Denial of Application to Reopen Workers Compensation Claim

Getting injured or sick on the job is a stressful time. You and your family probably depend on your income to get by. And it’s not just your work that’s affected; your entire quality of life and that of your family may be diminished. You are not able to enjoy your usual activities, and you may feel stress and depression at not being able to pursue your livelihood.

Often officials and doctors appointed by the state do not take the time to understand or show interest in your individual situation. If the State of Washington is not responding to your injury or illness as you think they should, it may be time to ask for help from an expert attorney.

What If the State Has Closed Your Claim?

If you have been injured on the job or have contracted an illness related to your work, you may have already received benefits based on your Workers Compensation claim. If your injury or illness is not permanent, at some point, the Washington State Department of Labor and Industry (L&I) will decide to close your claim. What happens if your injury or illness is still ongoing or gets worse after L&I closes the claim? Do you have recourse to reopen your claim?

Yes, you do. You may file to reopen a claim if your believe your claim has been closed prematurely or if your situation worsens—but be prepared; L&I may deny your application to reopen your claim if they feel you have no further basis for benefits.

Video: When Does My Workers Compensation Case Close?

What You Need to Know Before Reopening Your Claim

There are two situations in which you may need to reopen your claim:

You believe your claim was closed prematurely. If your job-related injury has not healed or your job-related illness is ongoing, and your case has been closed by the State, you may be able to reopen your case. You have 60 days from the time your claim was closed in which to protest or to appeal the closure of your claim.

Your condition worsens. If, after your case was closed, your job-related injury or illness worsens, you may file to reopen your case with L&I. You have a lifetime right to file for reopening under this circumstance. In most instances you have seven (7) years to file for reopening under this circumstance. You will need to have a doctor who, in his or her medical opinion, believes that your job-related condition is worse since the date your claim was closed.

If you and a doctor agree that your condition has worsened, you must demonstrate that the condition is related to your on-the-job illness or injury. Your worsened condition does not have to be the exact same injury or illness; it only needs to be related to it.

For example, if you injured your hip in an accident on the job, and that injury later led to problems with your back, you may file to reopen on the basis of your current back injury. In another example, if the stress of the injury or illness has affected your mental health, you may also have a basis for filing to reopen. Your doctor must be able to establish clearly that your condition has been aggravated since your initial claim and that any changes are related to the original injury or illness.

Video: Re-Opening A Workers Comp Claim – Explained

Whether your claim is reopened depends on the medical evidence. If you try reopen your claim for the physical component of your injury, then you must have a medical provider describe the objective medical evidence that supports the reopening of your claim, as compared to your medical condition at the time of the first claim closure.

What Happens When Your Application to Reopen Is Denied?

The Washington State Department of Labor & Industry may deny your application to reopen your claim. How do you proceed at that point? Do you have a way to recover benefits for your ongoing or worsened illness or injury?

You, your doctor, or your employer all have the right to protest or appeal L&I’s ruling. Calbom & Schwab, P.S.C., are experts at getting your claim reopened based on the appeal of any of these parties. We will work with you and your doctor to establish that your injury or illness has been aggravated and that you may be entitled to further benefits under the law.

You must file a protest or appeal the ruling within 60 days of the denial order from L&I, so contact an attorney right away to protect your rights.